Fenn Howard H, Sommer Barbara R, Ketter Terence A, Alldredge Brian
Menlo Park Division, Palo Alto Veterans Affairs Healthcare System, Menlo Park, California 94025, USA.
Expert Opin Drug Saf. 2006 May;5(3):401-16. doi: 10.1517/14740338.5.3.401.
The authors review current research on the safety and tolerability of anticonvulsant medications used for individuals over the age of 60 years with affective disorders, agitation and other psychiatric disorders. Three anticonvulsants currently approved in the US for treatment of bipolar affective disorder are reviewed: valproate, lamotrigine and extended-release carbamazepine. The authors discuss the pharmacokinetics, pharmacodynamics, drug-drug interactions and the impact of ageing for each drug. There are few studies of anticonvulsant medications in elderly patients with bipolar disorder or other psychiatric conditions. Therefore, the authors summarise adverse events of greatest prevalence and/or greatest severity based on data derived predominately from studies of geriatric patients with epilepsy and/or other non-psychiatric indications. Guidelines are offered for the safe use of these medications in the elderly, based on research literature.
作者回顾了目前针对60岁以上患有情感障碍、激越及其他精神障碍的个体使用抗惊厥药物的安全性和耐受性的研究。文中对目前在美国被批准用于治疗双相情感障碍的三种抗惊厥药物进行了综述：丙戊酸盐、拉莫三嗪和缓释卡马西平。作者讨论了每种药物的药代动力学、药效学、药物相互作用以及衰老的影响。针对双相情感障碍或其他精神疾病老年患者使用抗惊厥药物的研究较少。因此，作者主要基于来自老年癫痫患者和/或其他非精神科适应症研究的数据，总结了最常见和/或最严重的不良事件。基于研究文献，为老年人安全使用这些药物提供了指导原则。
